How much rates vary
Facilitymedian $2,630 · 10th to 90th $589 to $8,318Professionalmedian $417 · 10th to 90th $316 to $708
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,584.89 Median $4,365.16 Typical High $12,589.25 | Facility | None | $1,584.89 | $4,365.16 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $9,332.54 | Professional | None | $457.09 | $457.09 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $7,585.78 | Facility | None | $588.84 | $1,698.24 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $588.84 | Professional | None | $295.12 | $346.74 | $588.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $54.95 Typical High $95.50 | Professional | 80 · Assistant surgeon | $46.77 | $54.95 | $95.50 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $48.98 Typical High $83.18 | Professional | AS · PA/NP assist | $41.69 | $48.98 | $83.18 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $1,905.46 Typical High $2,454.71 | Facility | None | $512.86 | $1,905.46 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,754.23 Typical High $4,365.16 | Facility | None | $489.78 | $2,754.23 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $851.14 | Professional | None | $389.05 | $489.78 | $851.14 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $512.86 Median $2,754.23 Typical High $4,365.16 | Facility | None | $512.86 | $2,754.23 | $4,365.16 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $851.14 | Professional | None | $389.05 | $489.78 | $851.14 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $524.81 | Professional | None | $323.59 | $398.11 | $524.81 |
SummaCare Setting Facility Modifier None Typical Low $1,513.56 Median $1,584.89 Typical High $1,778.28 | Facility | None | $1,513.56 | $1,584.89 | $1,778.28 |
SummaCare Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $776.25 | Professional | None | $416.87 | $446.68 | $776.25 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,413.10 | Facility | None | $707.95 | $1,905.46 | $7,413.10 |
United Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $1,230.27 | Professional | None | $398.11 | $512.86 | $1,230.27 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $229.09 Typical High $794.33 | Professional | 52 · Reduced service | $229.09 | $229.09 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $316.23 | Professional | 53 · Discontinued | $91.20 | $91.20 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $1,202.26 | Professional | 54 · Surgery only | $338.84 | $338.84 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $239.88 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $158.49 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $1,122.02 |
Where Ohio sits
The same service costs 5.4 times more in Alaska than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Ohio· 50th of 51
$457
AK $2,239NY $417
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.